Remembering Louise Batz’s Tragic Death From Medical Error 10 Years Later

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Mark's note: This post is reprinted from an email from Laura Batz Townsend, the CEO of the Louise H. Batz Patient Safety Foundation. I asked to share it here, on the tenth anniversary of Louise Batz's tragic death that was caused by a preventable medical error in a hospital in San Antonio.

Please learn more about the important work the foundation is doing, check out their free Batz Guides for patients and families, and donate if you can. I've made an additional donation to their cause today beyond what we give from our “Practicing Lean” book proceeds… and I gave the breast cancer guidebook to a relative who was just diagnosed. These guides are much needed and are very helpful. Thanks.


By Laura Batz Townsend

I have been thinking about this day for a while, I knew that it was coming up, I have been reflecting a lot these past few months and what today would mean. I got up this morning headed down to Town Lake.

 One of my favorite things to do is to walk (run a little) around Town Lake in Austin.  It is my time to reflect, think, walk with friends, and just appreciate the serene beauty of the lake, trees, and wildlife.

I have so many memories over the years of talking with Mom on the phone while walking around the lake.  It was our time to catch up in the morning, strolling our girls, teaching them how to ride their bikes for the first time. There is one very special spot that I love in particular – a beautiful bank of rocks where you can sit and feed turtles and ducks and if you are lucky you will see the resident swans swimming in the water. They are the most beautiful and graceful creatures. They are truly majestic.

 I don't see them all the time, but when I do I feel very lucky and blessed.

Today I went to sit on those banks and think about my Mom and the past 10 years.

It is hard to believe that 10 years ago my Mom lost her life to a preventable medical error. What did that even mean?

[Read more about Louise's story]

My Mom went in to have routine knee surgery. She had been in pain for such a long time, but she always put on a brave face.  Mom scheduled her surgery right before Fiesta. She hated to miss Fiesta but she was bound and determined to be up and mobile before the birth of her fourth grandchild – Riley — who was going to be born in June.  I honestly wasn't too worried about it at all. My Dad had just recovered from Quintuple bypass surgery two months prior, so this was supposed to be no big deal.

I will always remember the doctor coming out to the waiting room and telling us that Mom did great and she had a beautiful new knee.

A huge weight lifted from my shoulders and I was so incredibly grateful that she had made it through with flying colors. We thought we were in the clear. I will never forget leaving her that night after the nurse told us to go home so she could get her rest. She gave me a big kiss and one of her beautiful smiles. I told her I would see her in the morning and that I was so proud of how she was handling her recovery. Dad and I left and I will wish every single day for the rest of my life that I had never left her room that night.

In one split second with a phone call at 3 am our world came crashing down in the blink of an eye. My Mom had gone into the hospital to get a knee replacement with such high hopes for the future.  However, a preventable medical error destroyed all of those dreams. I will never forget running down the long white hallway of the hospital and seeing the security guard standing outside my Mom's room and then feeling like a thousand knives went through my body all at once when I saw my Mom laying almost lifeless in her hospital bed. Everything had gone so terribly wrong.  

I will never forget the devastation of learning that my Mom's accident was not unique; that over 200,000 people die each year from preventable medical errors, making it the 3rd leading cause of death in the United States behind heart disease and cancer. I asked myself “how did I not know this? How did our family with five doctors not know this or ever talk about it?”

[See more patient safety statistics]

I sat with my Mom every day wishing to hear her voice, begging her to wake up. She had so much more life to live. She had so many more of her grandchildren's sporting events, art shows, music performances, birthdays, and family trips.  I wished I could turn back the clock and ask the right questions and take care of my Mom and save her life. I wish every day for one more chance. I just needed one more chance.

So many people tried to help Mom and save her life. We had so many friends around us during this time. Sharing stories of Mom, encouraging her to wake up by sharing fun stories. The outpouring of love during that time meant more to our family then we will ever be able to express in words. Those precious moments with friends and family are so very close to my heart. I remember all the Bible verses that were taped all around her bed. I still have them in my drawer. All of our friends that came from all over Texas and around the country to be there and sit with us at our most vulnerable and heart wrenching moments, giving us grace, comfort, love, hope, and serenity. Allowing us to be mad and cry yet find times to laugh. I know my Mom could feel all the love around her. Unfortunately it was not enough to save her.

The realization that my Mom was never going to get better and that we were powerless to help her was pure heartbreak. Having to say goodbye to Mom on April 26, 2009, was the hardest day of my life. Ten years ago today, I lost the best Mom and friend in the world. Ella, Mary Louise  and Sawyer lost their grandmother,  Riley lost the chance to ever meet his grandmother. Joanne, Charlie, Johnny, lost their sister. Will, Carl, Clay and Tommy lost their Aunt. So many of her friends lost a true and loyal friend. My Dad lost the love of his life.

Ten years ago today, we wrote the mission for the Louise H. Batz Patient Safety Foundation, because her story and her legacy were not going to end that day in the hospital.

My Mom always taught me that in times of great heartbreak to always have your faith, to never ever give up when times are hard. She would say we can fix any problem together, Most importantly she always taught me to never lose HOPE. Ten years ago Today my heart broke in a million pieces, but every single day for ten years our heartbreak has turned into a heart FULL of HOPE.

Together we have all gone on this amazing journey to change the culture of healthcare and patient safety not only in San Antonio but across the country and around the world. Our greatest hope is that patients, families, and healthcare professionals will work together, as a team, to improve patient safety through education and support in our hospitals and communities

No patient should have to go through their healthcare journey alone. We recognize these difficulties and have banded together from different backgrounds, educations and cultures to advocate for those with no voice, to educate others about decisions regarding their healthcare, to provide support to those who need more than just a treatment plan, and to foster confidence in an area where our intuition needs to stand alongside expertise.

Over the past ten years, The Louise H. Batz Patient Safety Foundation has raised over $2.5 million for patient safety. We have printed and downloaded over 40,000 Batz Guides that have been sent to hospitals, patients, and families around the world. We have shared my Mom's story across the United States, Canada, Europe and South America. This June we will be opening Batz Foundation Europe in Amsterdam.

Thank you all so much for going on this journey with us over the past 10 years. Thank you to all of our amazing friends and family who have been with us every step of the way. Thank you to all of our hospital partners, doctors, nurses, patient safety leaders that have supported us and helped us to develop the amazing Batz Guides and apps that are empowering families and saving lives every day. Thank you to all the wonderful families that have shared their stories and wisdom with us over the years. We could never ever do this without you.

As we start a new decade tomorrow I am so hopeful for the future and truly believe that we will continue to change the culture of patient safety and patient centered care.


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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

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